Providers Must Enroll to Prescribe for Medicaid Members

9/10/2018

Important Notice!
Providers Must Enroll to Prescribe for Medicaid Members 
On and after October 17, 2018, West Virginia Medicaid will begin to deny all claims for prescriptions written by any prescriber not enrolled with West Virginia Medicaid. This includes advanced nurse practitioners, physician assistants and pharmacists who administer vaccines. Eventhough the facitlity you are employed by (clinic, hospital or pharmacy) is currently enrolled, individual prescribers must also be enrolled. Failing to to enroll with West Virginia Medicaid as a prescribing provider could cause serious consequences for your patients.

The requirement for prescribers to enroll is a provision of the Patient Protection and Affordable Care Act of 2010. all prescribers serving Medicaid patients MUST enroll and their name and national provider identifier (NPI) must be recorded on claims for prescription medications submitted for Medicaid members on and after October 17, 2018. Providers may enroll as a billing provider or an ordering, referring, or prescribing (ORP) provider." ORP Only Provider" is a category for prescribers who write ordes, refer, or prescribe medications, but do not actually submit claims to Medicaid for their services. "ORP Only Providers" may not bill Medicaid for services.

If you are not already enrolled, please visit the West Virginia Medicaid claims processor, Molina Medicaid Solutions' website at:  https://www.wvmmis.com and enroll online as a biling provider or as an "ORP Only Provider." The quickest enrollment option is the ORP-Only online application process. A completed ORP application can be enrolled in five days. To prevent interruptions in Medicaid member's access to needed prescription medications, prescribers must make sure they are enrolled with West Virginia Medicaid.


Contact Information

For questions, please contact Molina Provider Enrollment at 888-483-0793 or the Molina Pharmacy Help Desk at 888-483-0801.
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